The study was conducted at three London HIV clinics (Royal Free and St Mary's Hospitals, Mortimer Market) between July 2013 and June 2018. During each six-month period, data were collected on number of first acute HCV diagnoses; re-infections; denominator of HIV-positive men who have sex with men (MSM) under active follow up; and access to early treatment.

A total of 293 acute HCV infections were identified - 246 first infections and 47 re-infections.

Incidence of first HCV episode peaked at 17.72/1,000 (95% CI 12.81-22.64) HIV+MSM person-years of follow-up (PYFU) in 2015. DAA treatment became widely available in late 2015 and by 2018, rates fell to 4.64 (95% CI 2.53-7.78).

Although re-infection rates increased from 9 to 16 per cent during the study period, the data show that there been a 74 per cent reduction in incidence of first HCV infection and 62 per cent reduction of overall HCV incidence in HIV+MSM since the epidemic peak of 2015.

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